Systematic review of evidence for the benefits of telemedicine
ABSTRACT A systematic review of telemedicine assessments based on searches of electronic databases between 1966 and December 2000 identified 66 scientifically credible studies that included comparison with a non-telemedicine alternative and that reported administrative changes, patient outcomes, or results of economic assessment. Thirty-seven of the studies (56%) suggested that telemedicine had advantages over the alternative approach, 24 (36%) also drew attention to some negative aspects or were unclear whether telemedicine had advantages and five (8%) found that the alternative approach had advantages over telemedicine. The most convincing evidence on the efficacy and effectiveness of telemedicine was given by some of the studies on teleradiology (especially neurosurgical applications), telemental health, transmission of echocardiographic images, teledermatology, home telecare and on some medical consultations. However, even in these applications, most of the available literature referred only to pilot projects and to short-term outcomes. Few papers considered the long-term or routine use of telemedicine. For several applications, including teleradiology, savings and sometimes clinical benefit were obtained through avoidance of travel and associated delays. Studies of home care and monitoring applications showed convincing evidence of benefit, while those on teledermatology indicated that there were cost disadvantages to health-care providers, although not to patients. Forty-four of the studies (67%) appeared to have potential to influence future decisions on the telemedicine application under consideration. However, a number of these had methodological limitations. Although useful clinical and economic outcomes data have been obtained for some telemedicine applications, good-quality studies are still scarce and the generalizability of most assessment findings is rather limited.
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ABSTRACT: OBJECTIVE: The purpose of this paper is to evaluate the efficacy and cost-effectiveness of the implantable Doppler system based on the analysis of the available scientific literature and clinical and cost data available in our hospital. The results of this system are compared to those of conventional free flap monitoring methods. MATERIALS AND METHODS: The literature published between 1991 and 2011 was systematically reviewed. All available cost data were collected and several simulations were performed. A retrospective assessment of the efficacy of conventional methods in our hospital was also conducted. RESULTS AND CONCLUSION: The implantable Doppler system is more effective than the conventional methods used to monitor free flap perfusion. The mean flap salvage rate with the implantable Doppler was 21 percentage points higher (81.4 vs. 60.4). The excess cost compared to conventional methods was about CAD 120 per patient (about EUR 94). However, this excess cost can be compensated or even reversed, depending on the initial flap salvage rate in the health facility and the type of free flap (buried vs. non-buried).European Annals of Otorhinolaryngology, Head and Neck Diseases 04/2013; 130(2):79-85. DOI:10.1016/j.anorl.2012.07.003
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ABSTRACT: It is estimated that global climate change and regional land use and cover changes in the Amazon region will contribute to the spread of vector-borne diseases such as bartonellosis and leishmaniasis. The large geographical distances and the sparsity of human settlements in the region pose challenges to the collaboration among health professionals whose goals range from diagnosing diseases to monitoring their spread. This paper presents work in progress on a system to support the tasks of local healthcare professionals and enabling collection, compilation, sharing and visualisation of data for purposes of epidemiological research and disease surveillance in remote regions.Computer-Based Medical Systems (CBMS), 2012 25th International Symposium on; 01/2012
- The 12th Panhellenic Conference on Informatics (PCI 2008), Samos, Greece; 08/2008